Painkiller is the first Judas Priest album to feature drummer Scott Travis, who replaced long-time drummer Dave Holland in 1989. Travis was previously a member of Los Angeles band Racer X and with his heavy use of double pedals and blast beats, it gave Judas Priest a new sound and heavier edge.

The album was recorded at Miraval Studios, Brignoles, France in early 1990 and mixed at Wisseloord Studios, Hilversum, the Netherlands later that year. It was produced by the band and Chris Tsangarides, marking the first time since 1978's Killing Machine that Judas Priest had not worked with Tom Allom and the first time since 1976's Sad Wings of Destiny that Judas Priest and Tsangarides worked together.